CTG umbungu - kuyinsakavukela. CTG umbungu - izinga lange -36. Indlela wokufunda CTG umbungu

Kasibili njalo owesifazane ngesikhathi sokukhulelwa sokukhathazeka mayelana kanjani ukuthuthukisa ingane yakhe, yonke into ukuze wakhe. Namuhla, kunamabandla amasu ezivumela isilinganiso onokwethenjelwa ngokwanele umbungu. Enye indlela ezinjalo kuba cardiotocography (CTG) ikhomba ubudlelwano phakathi perturbation ne-fetus ube kwenhliziyo. Kulesi sihloko uzofunda ukuthi CTG, mayelana nokuthi ukusebenza yakhe esikalini, okuyiwona izinkomba CTG umbungu - kuyinsakavukela khona, nokuthi kuthinta imiphumela yocwaningo.

Uyini CTG

Cardiotocography esekelwe ukubhaliswa imvamisa fetus kwenhliziyo futhi siyashintsha kwethonya ezenzeka ngaphandle noma umsebenzi fetus.

Sifo is ezenziwe ngokusebenzisa izinzwa ezimbili ultrasonic, enye yazo zigxilé esiswini a abesifazane abakhulelwe, pre-belinganisa esifundeni ezinhle audibility ukushaya kwenhliziyo ingane. Kuhloswe ukurekhoda umsebenzi inhliziyo umbungu. Izinzwa inzwa kubonakala kusuka enhliziyweni ingane isignali ultrasonic, okuyinto ke iguqulwe ngu ngekhompuyutha ukuba leso kwenhliziyo. Inzwa yesibili eqondiswa esiswini esibelethweni. Ilandisa Kufinyeta lesizalo. Ukuze uthuthukise ukudluliswa ultrasonic wave izinzwa okwenziwa ngumuntu gel ekhethekile. Futhi, amadivayisi yesimanje anemisila elawulwa kude ngokuchofoza ukuthi inkinobho, owesifazane okhulelwe bangase bazibone ukunyakaza kwengane.

Imiphumela ayaboniswa kudivayisi itheyiphu ngesimo igrafu. Kukhona futhi uboniswa lesizalo Kufinyeta nokunyakaza fetus. Idatha etholwe kungenziwa yahlulelwe ngokuyinhloko isimo isimiso sezinzwa ingane, ukusabela kwayo yisivikelo futhi eguquguqukayo. Uma izinkomba CTG umbungu - kuyinsakavukela khona, kusho ukuthi ingane ezizwa, nokuthuthukiswa ukuqhutshwa zalo ngokwenkonzo nezinsuku.

Edinga CTG

Ukuhlola owesifazane owayezithwele ehhovisi i Udokotela Wabesifazane uhlanganisa ukulalela ukushaya kwenhliziyo wengane nge IselulekoSesihenqo. Ukusuka kusukela yinto evamile ukukhuluma ukushaya kwenhliziyo (HR) ku phezulu noma phansi ibonisa ukuthi ingane ihlangabezana ukungakhululeki. Kulokhu, lo dokotela ithumela umama esizayo balifundisise ngaphezulu esimiso senhliziyo nemithambo yegazi umbungu - CTG.

Kukhona ubuhlobo okucacile phakathi inhlalakahle owesifazane okhulelweyo umbungu. Ngakho, uma umuntu ekhulelwe kwakulula, ngaphandle ukutheleleka intrauterine, kokuphazamiseka usongo, preeclampsia, imiphumela CTG, kungenteka babe evamile. Uma umuntu wesifazane okhulelwe siyimiqemane waphawula osolisayo CTG imiphumela, kubalulekile ukuqhuba ucwaningo ngeviki futhi.

Uma umuntu wesifazane okhulelwe wathola izinguquko sína isimo sezempilo, kubalulekile njengoba CTG ingenziwa kaningi ukuze kuvinjelwe indawo okuvela kuyo amazwi kwezinso isikhathi kwengane esiswini bese uthatha izinyathelo ezidingekayo.

Izici cwaningo

Yabela CTG ngokuvamile ngemva kwamasonto angu-32 okukhulelwa ngoba kuphela kulesi sikhathi kukhona ukukhula kwamanyuroni pulses, futhi indlela iba ngaphezulu ulwazi.

Ngokwesibonelo, i-fetus CTG izinga amasonto 33 - ebukhoneni igrafu engaphezu kwemibili aktseleratsy. Ngalesi sikhathi, baba zibangelwa kwemizwa uhlelo ephendula ukunyakaza kwengane noma iziphi izici zangaphandle. kungenzeka Emhlanganweni ngaphambili aktseleratsii esiteji ehambisana ne-nemibandela khona intrauterine umbungu, ngakho ucwaningo kungaholela Imiphumela zamanga.

Futhi, ngalesi sikhathi-fetus Kumiswa umjikelezo umsebenzi futhi ukuphumula, okuyinto ebaluleke kakhulu kulolu cwaningo. Phakathi CTG e lonke umbungu ngesikhathi Imiphumela yako ihlale sengqondo esiqondile, ngisho uma empeleni kukhona izinga eliphakeme hypoxia. Yingakho lolu cwaningo okufanele iqhutshwe okungenani imizuzu engu-40. Phakathi nalesi sikhathi, i-fetus nakanjani ukwandisa umsebenzi ngokomzimba, okuzokwenza ukubhalisa ushintsho kwenhliziyo ngesikhathi ukuhamba kwayo.

Kubalulekile kakhulu owesifazane azizwe ekhululekile futhi zikhululekile ngesikhathi sesivivinyo. Kuvele isikhundla kwambangela imizwa elikhanyayo kungabangela ukunyakaza bakhuthele fetus, okuyoholela Imiphumela zamanga. Ngokuvamile, phakathi naleyo nqubo owesifazane esihlalweni ukhululekile noma elele phezu kombhede ezinsikeni zawo.

Ukuze uqonde ukuthi wokufunda CTG umbungu uzobona it is kahle indlela sihlolwe nemingcele.

Basal kwenhliziyo

I-basal kwenhliziyo - emaphakathi kwenhliziyo umbungu, eyenzelwe imizuzu 10-20. Okunqumayo ngokungabi bikho ukunyakaza kwengane phakathi lesizalo Kufinyeta ngaphandle ezintweni ezenzeka ngaphandle, ngaphandle aktseleratsy futhi decelerations. Lapho uqhuba fetus CTG BCHSS izinga 110-160 ngomzuzu. Tachycardia, ie ngenhla evamile basal kwenhliziyo, kungabonakala nasemkhakheni hypoxia fetus, ukuntuleka kwegazi emzimbeni, kombungu ne-fetus ube inhliziyo umsebenzi esingamahlalakhona, kanye isimo okunomkhuhlane zokukhulelwa, khona ukutheleleka wakhe intrauterine, ekuthuthukiseni umsebenzi yegilo. Ukuthola imithi ukuthi nethonya kardiostimuliruyuschy kungaholela ukwanda inhliziyo yengane.

Ukwehlisa izinga basal ingezansi evamile (bradycardia) kungadalwa hypoxia, fetus inhliziyo yayo yayinezinkinga ezicini, kanye umfutho ophansi wegazi kukamama, hypoxemia, kokucindezelwa eside umzanyana, khona abesifazane abakhulelwe CMV ukutheleleka.

Kwenhliziyo variability

Lolu khetho libhekene oscillations leso - kwenhliziyo ngeziphambeko kusukela ezingeni basal. Lapho ehlaziya CTG ngokuvamile ukufunda amplitude leso sikhathi of oscillations, ubunjalo okuyinto secrete oscillation ongaphakeme (ukuphambuka kuyinto amabhithi engaphansi kwemithathu / iminithi), eliphakathi (3-6 amabhithi / iminithi), ephezulu (amplitude phezu 6 amabhithi / iminithi).

Ukuze CTG izinga fetus zamaviki 36 - oscillation eliphezulu, okubonisa inhlalakahle umbungu. Ukuba khona oscillation ongaphakeme uthi pathologies sokugcwaliseka kwaso.

Ngokukhethekile ikhokhelwa imitsetfo yekuhlatiya kardiotokogramm oscillations kancane. Kuye amplitude yabo ukuhlukanisa ngephimbo elifanayo uhlobo, esibonakala by ongaphakeme amplitude oscillations (0 kuya ku-5 Beats / iminithi), uhlobo ushintsho nge amplitude kusuka amabhithi 6 kuya ku-10 / imiz, corrugating (11 kuya ku-25 amabhithi / iminithi) kanye nohlobo agijima (amplitude ngenhla 25 amabhithi / iminithi). oscillation Ukwandiswa amplitude kungenzeka ukuthi umataniswe ngokulinganisela hypoxia fetus, kanye nethonya ezenzeka ngaphandle ukufukula uhlelo lwayo sezinzwa. Nciphisa amplitude oscillation kungadalwa hypoxia ezinzima okuholela okusithiyayo umsebenzi isimiso sezinzwa umbungu, ngokusebenzisa nezidakamizwa, zinhlungu.

Aktseleratsii

Aktseleratsiey ngokuthi palpitations yesikhashana okungenani 15 amabhithi / imiz kuqhathaniswa ezingeni basal ubude besikhathi amasekhondi angu-15. On kardiotokogramme Babukeka njengezihlahla namazinyo okusezingeni eliphezulu. Aktseleratsii Uyi impendulo ezintweni ezenzeka ngaphandle, Kufinyeta kwesibeletho, ukunyakaza kwengane. Ukuba khona kwabo phezu CTG umbungu - kuyinsakavukela.

decelerations

Detseleratsii ngokuthi okwehlisa izinga inhliziyo umbungu okungenani ngo-15 amabhithi / imiz isikhathi eside kunaleso 15 imizuzwana. Igrafu ebonisa ukucindezeleka okukhulu kangakanani. Kukhona ekuseni, sekwephuzile futhi decelerations onhlobonhlobo. Ngaphezu kwalokho, ihlukaniswa njengoba amplitude ukukhanya nge ukwehla kwenhliziyo 30 amabhithi / imiz, ngokulinganisela - 30 - 45 amabhithi / imiz, futhi ezinzima - kusuka 45 amabhithi / imiz. Okwehlisa izinga lokushaya kwenhliziyo kungenzeka kubangelwa iziyaluyalu esinomhlapho ukugeleza kwegazi, hypoxia esivimba amanzi, ecindezela umzanyana.

CTG umbungu. kuyinsakavukela

Ukuze ukuhlolwa kwe-fetus, World Health Organization isungule imihlahlandlela ukuthi ucacise minimum futhi esiphezulu amanani ovumelekile ipharamitha ngamunye. Ngokusho lezi ziqondiso, CTG umbungu (sivamile amasonto 33) Kufanele ube zincazelo:

• Basal kwenhliziyo: 110-160 amabhithi / imiz.
• Kwenhliziyo variability ku ezahlukene 5-25 ishaya / imiz.
• Ababili noma ngaphezulu ukusheshisa angu-10.
• Ukuswelakala kokusebenza ngokuhlanganyela decelerations ezijulile.

Kuyaphawuleka ukuthi izinga fetus CTG 35 amasonto noma ngaphezulu kuyafana emasontweni 33.

ukuhlolwa kwengane ngamaphuzu

Lokubhala imiphumela CTG 10-iphuzu esikalini, ahlola umbandela ngamunye kusukela amaphuzu 0 kuya 2. Ukuze CTG izinga fetus zamaviki 36, kanye kulo lonke yokuthathu yesithathu, kuba 9-10, uma amaphuzu ingqikithi 6 kuya ku-8, kuthiwa i-oksijini yokulamba (hypoxia) ngaphandle izinsongo esengeziwe, kufanele usuphinda CTG lingakapheli isonto; Uma 5 amaphuzu noma ngaphansi - ke ingane izizwa eziqine ukuntuleka komoya-mpilo, okungaholela nezinkinga ezingathi sína esithinta izinzwa, udinga izinyathelo ezisheshayo.

Kumele kukhunjulwe ukuthi ngisho uma CTG fetus 8 amaphuzu noma ngezansi, akudingekile ngaphambi kwesikhathi sokwethuka. Kulesi hlobo cwaningo, kanye nabanye abaningi, kukhona izinto ezithinta okuqukethwe Imininingwane wobufakazi. Imiphumela bathembele kakhulu, ngokwesibonelo, ngabe ingane ilele noma uphapheme. odokotela abanolwazi e sokuqonda kardiotokogramm acabangele izici ezifana sezulu, isimo abesifazane abakhulelwe, amazinga igazi glucose bangabesifazane. Uma idatha CTG akuzona efanele, ngaleso sikhathi udokotela imithi ukuhlolwa eyengeziwe. Cardiotocography ngokuvamile eyenziwa kabili yokuthathu yesithathu yokukhulelwa, kodwa kwezinye izimo nakakhulu, ezifana e nokukhulelwa izingane eziningi ngasikhathi, umfutho wegazi ophakeme, khona izifo, isifo sikashukela, imiphumela abanelisi of ultrasound, ukopha, Kufinyeta kwesikhathi.

amaphutha olungenzeka ukuhumusha CTG idatha

1. I ingane esibelethweni siyahamba njalo. Ngezinye izikhathi unganciphisa ikhanda lika umzanyana, yingakho esikhathini esifushane kuyaphazamiseka ukugeleza kwegazi izitsha umzanyana, njengoba kubonakala imiphumela CTG. Kulokhu, kardiotokogramma kuyodingeka isimo sokugembula ngezithelo ezinhle.
2. Ngezinye izikhathi phakathi ukuntula-mpilo ku-fetus zihlanganisa ukusabela ukuzivikela: ukuncipha-mpilo consumability kwezicubu ukwandisa ukumelana hypoxia. Ezimweni ezinjalo, umntwana ehlupheka, kodwa akuphazamisi CTG.
3. With ukuthuthukiswa zokugula zingancishiswa nekhono lokuqonda izicubu at okuqukethwe oxygen evamile egazini, ngenxa lapho umbungu kwenzeka Akwenzekanga lutho, futhi uqale ezivamile, nakuba uhlushwa ukuntuleka komoya-mpilo.

Uma sicabanga ngakho konke okungenhla, kufanele kuqondwe ukuthi CTG umbungu ngesikhathi sokukhulelwa indlela ebaluleke kakhulu sifo, kodwa ukuze uthole isithombe esiphelele salokho okwenzeka idatha CTG kumele, uma iqhathaniswa nezinye izifundo. Namuhla kabanzi futhi Doppler ultrasound uphethwe.

Lapho ungenza CTG umbungu

CTG ukwenza mahhala kuzo zonke emtholampilo yabakhulelwe. Kungenzeka ukuba afeze ucwaningo kanye nezikhungo zezokwelapha yangasese, kodwa imali.
Izibhedlela futhi afeze cardiotocography ngesikhathi sokubeletha. Lokhu kusiza ukuhlola isimo impilo umntwana ngesikhathi sokubeletha Kufinyeta futhi uhlole ukuphumelela ukwelashwa kanye ukulethwa amacebo.

Abanye omama abakhulelwe bayesaba ukuchitha ehlukile ucwaningo ngesikhathi sokukhulelwa, bekholelwa ukuthi ekwazi ukulimaza impilo usana olungakazalwa. Cardiotocography ngokuphelele ephephile, futhi kungenziwa kaningi ngendlela kunesidingo, ngaphandle empilweni. Ngaphezu kwalokho, kuyinto kobuhlungu, akubangi ukungakhululeki.

Sifisela wena ukukhulelwa lula nenhlalakahle!